Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Jenner Health Centre on 5 July 2016. The overall rating for the practice was good with requires improvement in the safe domain. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Jenner Health Centre on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 14 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection on 5 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice sent in an action plan informing us about what they would do to meet legal requirements in relation to the following;

• The provider did not have robust systems in place to ensure that patients receiving long term thyroxine medication all received blood monitoring tests to manage their condition effectively.

During the initial inspection we also found areas where improvements should be made:

• Develop a standard operating procedure for the safe destruction of controlled drugs and for the management of repeat prescription requests. Ensure that staff are familiar with, and follow these policies.
• Strengthen systems for monitoring incoming medical letters and patient safety alerts.
• Consider completing a risk assessment of the medicines carried by the GPs during home visits so that patient need and the safe management of medicines is considered.
• Improve the uptake of new patient health checks.
• Continue to prioritise work around the feedback received from patients in the national GP patient survey.

The practice told us these issues were addressed and have provided us with evidence to show they had taken the action to address the concerns.

Overall the practice is rated as good.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Jenner Health Centre on 5 July 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed although the management of safety alerts and the monitoring of patients prescribed Thyroxine needed to be strengthened to ensure patient safety.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they had difficulty making an appointment with a named GP although urgent appointments were usually available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw three areas of outstanding practice:

• The practice had set up a counselling service for young people registered at the practice in response to a gap in service provision for this age group. It had been extended to other local practices in the area and funded by the Clinical Commissioning Group. Patients were able to self-refer and the service had an average list size of approximately 13 patients at a time.

• The practice had taken a lead role in the development of the out of hours GP service in Peterborough which included a weekend service in the local hospitals accident and emergency department.

• A GP at the practice had set up a community DVT service (for treatment and diagnosis of deep vein thrombosis) which initially covered three local practices. This provided a pathway of care for patients based on guidelines issued by the National Institute for Health and Care Excellence (NICE). The service served the Peterborough area and enabled patients to be assessed and treated without needing to attend hospital. The service met patient’s needs and preferences and had been very cost effective.

The areas where the provider must make improvements are:

• Ensure that patients with long term conditions receive the appropriate monitoring tests to reduce any risks to their health and manage their conditions effectively.

The areas where the provider should make improvements are:

• Develop a standard operating procedure for the safe destruction of controlled drugs and for the management of repeat prescription requests. Ensure that staff are familiar with, and follow these policies.

• Strengthen systems for monitoring incoming medical letters and patient safety alerts.

• Consider completing a risk assessment of the medicines carried by the GPs during home visits so that patient need and the safe management of medicines is considered.

• Improve the uptake of new patient health checks.

• Continue to prioritise work around the feedback received from patients in the national GP patient survey.  

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at Jenner Health Centre on 17 August 2015. This was to follow up on issues that we identified during an inspection on 26 August 2014, conducted as part of our pilot inspection programme.  

Our key findings across the areas we inspected were as follows:

• Arrangements for the safe management of medicines were in place and appropriate systems were followed by competent dispensary staff.
• Systems to monitor infection control and cleanliness within the practice had been strengthened. A refurbishment plan was in place and the practice had taken steps to ensure that the environment promoted good infection control practice. A process was in place to ensure that medical instruments were cleaned appropriately.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Remind staff about their responsibilities for packaging used instruments that require decontamination in accordance with practice guidelines.

This practice has not yet received a rating and will receive a full comprehensive inspection in the near future.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Jenner Health Centre provides a range of primary medical services to approximately 7,900 people from their premises in Turners Lane, Whittlesey.

During our visit we spoke with 13 patients and two representatives of the practice’s patient participation group (PPG). A PPG is a group of patients that work together with GPs to improve services and to promote health and improve the quality of care. We spoke with ten members of staff including two GPs and two nurses. We looked at procedures and systems and considered whether the practice was safe, effective, caring, responsive to patients’ needs and well led.

All of the patients we spoke with were very complimentary about the service. They told us that they were treated with respect and they were satisfied with the care and treatment they received. We saw that the results of patient surveys carried out by the practice showed that patients were pleased with the service and that the practice had responded to their views and complaints.

We met and listened to the views expressed by several support organisations for vulnerable people at a public listening event. We consulted with the Clinical Commissioning Group (CCG) the NHS England Local Area Team and with Local Healthwatch.

We examined patient care across six population groups: older people, people with long term medical conditions, mothers, babies, children and young people, working age people and those recently retired, people in vulnerable circumstances who may have poor access to primary care and people experiencing poor mental health. We found that care was tailored appropriately to the individual circumstances and needs of patients in these groups

We found that Jenner Health Centre had procedures in place for reporting, recording and analysing significant events and incidents. There were procedures for the safeguarding of vulnerable adults and children.

The practice had procedures in place to deliver care and treatment to patients in line with the appropriate standards. We also saw evidence of effective working with multidisciplinary teams.

The practice was responsive to patients’ needs. Patients were given the opportunity to give their views and the practice demonstrated they listened to and responded to their patient participation group.

We found that improvements must be made to the safe prescribing and storage of medicines.

Improvements must be made to the practice’s infection control procedures.

Improvements should be made to the practice’s policy for safeguarding vulnerable adults.

The practice should ensure that patient’s privacy is maintained whenever patients use an examination couch.

Improvements should be made to the analyses and shared learning around significant events to ensure nurses are included in this process when it is appropriate.

Please note: that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this information relates to the most recent information available to the CQC at that time.